Acute Intestinal Obstruction

What is acute intestinal obstruction?

Bowel obstruction in the large intestine
Photo credit: St Vincent’s University Hospital
Bowel obstruction in the small intestine
Photo credit: Shutterstock

Acute intestinal obstruction refers to a condition in which the flow of intestinal contents, such as food and digestive juices, is hindered by some kind of blockage. It can occur anywhere along the gastrointestinal tract, such as the large and small intestine.

Intestinal obstruction can be partial or complete. In partial obstruction, some of the intestinal content can still pass through, but in complete obstruction, the flow of digestive material is completely stopped, and immediate medical intervention is required to fix it. 

How serious is acute intestinal obstruction?

As intestinal content accumulates in the digestive tract behind the blockage, it damages the surrounding tissue. If left untreated, acute intestinal obstruction can cause parts of your intestine to die (ischemia), leading to impaired absorption of nutrients. 

Furthermore, when there is sufficient pressure due to accumulation, it can lead to the rupturing of the intestine. This tearing can result in the leakage of toxic substances and bacteria from the intestine into the abdominal cavity, posing a life-threatening situation due to septic shock 

However, with timely medical care, most cases of intestinal obstruction can be completely resolved.

Partial intestinal obstruction can be treated with no surgery involved. In some cases, you will be given an intravenous (IV) line to supply fluids and medications, bowel rest followed up with a low-fibre diet to be consumed for a few days if bowel activity resumes. However, surgery may be needed if it does not resolve within a week or investigations show worsening obstructive features. 

Complete intestinal obstruction requires urgent surgery. Typically, the surgeon will remove the obstruction together with parts of the intestine that have been damaged. 

So, even though it can result in adverse complications, acute intestinal obstruction is a very treatable condition. 

What causes acute intestinal obstruction?

Several conditions can cause intestinal obstruction. Acute intestinal obstructions are most commonly caused by adhesions in the abdomen that form post-surgery, hernias, colon cancers and twisting of bowel loops. In some cases, ingesting foreign objects can also cause intestinal obstruction. 

What are the symptoms of acute intestinal obstruction?

Intense and often debilitating pain in the abdomen is a hallmark symptom of acute intestinal obstruction.

Acute intestinal obstruction typically involves a few of the following symptoms:

  • Severe abdominal pain and cramping
  • Loss of appetite
  • Having difficulty eating or drinking without experiencing discomfort or adverse reactions
  • Vomiting that is persistent and forceful, possibly containing blood
  • Abdominal bloating and swelling
  • Constipation or diarrhoea
  • Fever and signs of infection

Is acute intestinal obstruction painful?

The abdominal pain associated with intestinal obstruction is often described as ‘crampy’. Since it comes and goes, it is incredibly uncomfortable and quite often bad enough to disrupt daily activities and sleep. 

When complications such as infections occur, the pain can become ceaseless and completely unbearable without painkillers. Thus, it is crucial to get immediate medical attention if you experience intestinal obstruction. 

Who is at risk of acute intestinal obstruction in Singapore?

Acute intestinal obstruction is more likely to occur in people who:

  • Had previous surgery on the abdomen
  • Suffer from colon cancer
  • Have hernias

When should you visit the A&E for acute intestinal obstruction?

It is vital to immediately seek help from a general surgery clinic or call 995 to contact a nearby hospital’s Accident and Emergency (A&E) Department if you experience symptoms of acute intestinal obstruction, such as severe abdominal pain and cramping, persistent and forceful vomiting, and abdominal bloating and swelling. You should not ignore these symptoms as they are signs of a medical emergency that requires timely treatment. 

ACE Specialist Surgery and Endoscopy Clinic offers round-the-clock emergency services for acute intestinal obstruction cases. Patients experiencing acute intestinal obstruction in Singapore can seek medical attention at any time for diagnosis and treatment. You can call us any time of the day (24/7), and we will arrange a consultation or urgent operation with our general surgeon as soon as possible.

How is acute intestinal obstruction diagnosed?

After informing our general surgeon  about your symptoms, if there is a possibility of intestinal obstruction, one or more of these diagnostic tests may be run on you:

  • Physical Examination: Our general surgeon will inquire about your medical history and conduct a physical examination to assess your condition. Signs such as abdominal swelling, tenderness, or a lump may raise suspicion of intestinal obstruction. Bowel sounds may also be evaluated using a stethoscope.
  • X-ray: To confirm the diagnosis, an abdominal X-ray may be recommended. However, it is important to note that some intestinal obstructions may not be visible through standard X-rays.
  • Computerised Tomography (CT) Scan: A CT scan uses X-ray images captured from different angles to create intricate cross-sectional images. This method is more effective than a standard X-ray and can provide a more precise visualisation of an intestinal obstruction.
  • Ultrasound: In cases of intestinal obstruction in children, ultrasound is often the preferred imaging technique. 
  • Air or Barium Enema: For certain suspected cases of obstruction, an air or barium enema may be performed to enhance imaging of the colon. In this procedure, air or liquid barium is introduced into the colon through the rectum.

What are the treatment options for acute intestinal obstruction in Singapore?


In Singapore, effective treatment options for acute intestinal obstruction are widely available. After you arrive at our specialist clinic, you will be stabilised so that further diagnostic and treatment procedures can take place. This may involve:

  • Inserting an intravenous (IV) line into a vein in your arm to administer fluids and medicine
  • Introducing a tube through your nose and into your stomach (nasogastric tube) to extract air and fluid to alleviate abdominal swelling
  • Placing a slender, flexible tube (catheter) into your bladder to evacuate urine and gather samples for testing.

If you have a complete obstruction, you can also expect:

  • Bowel resection surgery:  The surgery, also known as partial colectomy,  removes the obstruction as well as the intestinal tissues that have died or become damaged beyond repair. This procedure is essential to restore proper digestive function and prevent further complications. Our general surgeon may use minimally invasive laparoscopic (keyhole) techniques or open surgery, depending on the complexity and severity of the obstruction.  
  • Colonic stenting: The alternative treatment of inserting a self-expanding metal stent (SEMS) through your colon to forcefully open up the intestine. Stenting alleviates obstructions and allows for the passage of faecal material. It is useful for locally advanced colon cancers to optimise patients.


Acute intestinal obstruction is characterised by the flow of intestinal contents, such as food and digestive juices, being hindered by some kind of blockage. It is a potentially fatal condition that can happen to anyone and has the potential to develop into serious complications. However, with a quick response, it can be controlled in most cases. 

Visit ACE Specialist Surgery & Endoscopy

If you are suffering from acute intestinal obstruction or suspect that you may be suffering from one, call us to schedule an appointment with ACE Surgery and Endoscopy for a detailed examination and guidance on suitable treatment options. Our Senior Consultant Endocrine and General Surgeon, Dr Reyaz Singaporewalla, who has over 25 years of experience in general surgery, will handle your medical emergency.


  1. Intestinal Obstruction. Mayo Clinic
  2. What to know about bowel obstruction and blockage. Medical News Today